Military officials were instructed not to publicly discuss a decision made in January 2002 to presumptively treat all Guantanamo detainees with a high dosage of a controversial antimalarial drug that has been directly linked to suicide, hallucinations, seizures and other severe neuropsychological side effects, according to a retired Navy captain who signed the policy directive … //

… Benefits Outweighed Risks:

Shimkus, who is a nurse by training, acknowledged that the mass presumptive treatment of malaria using mefloquin was unprecedented. However, he said the “benefits outweighed the risks.”

When asked, Shimkus did not indicate that contraindications for the use of mefloquine, such as pre-existing cases of post-traumatic stress disorder, anxiety, seizures. or other mental illness, which would have heightened mefloquine’s side effects, were ever pursued for the individual detainees. He simply reiterated that the benefits of administering treatment doses of mefloquine outweighed the risks.

Yet, when told that the Defense Department took a radically different approach a decade earlier, when thousands of Haitian refugees housed at Guantanamo were first tested to determine if they had malaria and, only then, were given a treatment dosage of a different medication, chloroquine, if they had the disease, Shimkus said war on terror detainees “were a different cohort of individuals.”

“You have to remember that this was in the context of February 2002,” Shimkus said. “The detainees came from Afghanistan and other areas that may have been chloroquine resistant.”

Moreover, in two articles published in 2002, Shimkus claimed statistics showed that 40 percent of Afghanistan’s population was infected with malaria. But according to figures from the World Health Organization, in 2002, the number infected in Afghanistan was about 13 percent.

Shimkus also indicated that malaria cases at Guantanamo could have led to a public health crisis at the base, and reintroduction of malaria into Cuba. Once an outbreak begins, Shimkus told Truthout, one “loses control” of the situation and there is an epidemic.

However, when the CDC examined the influx of tens of thousands of refugees to the United States from hyper-epidemic sub-Saharan Africa, where the falciparum form of malaria kills more than a million people yearly, they concluded that “sustained malaria transmission” in a nonmalarial endemic country, like the US, from this population “would be unlikely.”

Still, the CDC called for mass presumptive treatment (with a drug other than mefloquine) of these refugees before they came to the US – mainly because they feared many US doctors wouldn’t recognize malaria symptoms – but noted that such mass presumptive treatment from other parts of the world, including Afghanistan, was not recommended, because “the risk and cost of post-arrival presumptive treatment currently outweighs the potential benefits.”

Of the more than 700 detainees held at Guantanamo, only four tested positive for malaria, all in January and February 2002.

But Shimkus still defended the mass administration of mefloquine, saying, “One [infection] is too many.” Shimkus said he believes he and other military officials “made the right policy decisions based on the information we had to prevent the introduction of malaria” in Cuba and protect the health of the detainees.

Shimkus said after he retired from the military he became involved with the Open Society Institute, funded by the Soros Foundation, and has since taken a role in the work the organization has done to raise awareness about abusive interrogation measures contained in the Army Field Manual. (full text).